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General NPI Number Information
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NPI Number | 1477479830
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Entity Type | Individual
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Provider Name | SHAYLA MARTINEZ
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Gender | Female
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 180 N UNIVERSITY AVE
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City | PROVO
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State | UT
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Zip | 84601-5647
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Country | US
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Telephone | 385-287-8432
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Fax |
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Provider Business Mailing Address
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Address Line | 17579 S TUNNEL RD
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City | ELBERTA
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State | UT
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Zip | 84626-7742
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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